PT  - JOURNAL ARTICLE
AU  - Tan, Qiang
AU  - Wang, Qingsheng
AU  - Liu, Dongtian
AU  - Zhang, Shuangyue
AU  - Zhang, Yang
AU  - Li, Yang
TI  - Intravascular ultrasound-guided unprotected left main coronary artery stenting in the elderly
AID  - 10.15537/smj.2015.5.11251
DP  - 2015 May 01
TA  - Saudi Medical Journal
PG  - 549--553
VI  - 36
IP  - 5
4099  - http://smj.org.sa/content/36/5/549.short
4100  - http://smj.org.sa/content/36/5/549.full
SO  - Saudi Med J2015 May 01; 36
AB  - Objectives: To investigate whether intravascular ultrasound (IVUS) guided percutaneous coronary intervention (PCI) could improve clinical outcomes compared with angiography-guided PCI in the treatment of unprotected left main coronary artery stenosis (ULMCA) in the elderly.Methods: This controlled study was carried out between October 2009 and September 2012, in Qinhuangdao First Hospital, Hebei Province, China. One hundred and twenty-three consecutive patients with ULMCA, aged 70 or older, were randomized to an IVUS-guided group and a control group. The occurrence of major adverse cardiac events (MACE): death, non-fatal myocardial infarction, or target lesion revascularizations) were recorded after 2 years of follow-up.Results: The IVUS-guided group had a lower rate of 2-year MACE than the control group (13.1% versus 29.3%, p=0.031). The incidence of target lesion revascularization was lower in the IVUS-guided group than in the control group (9.1% versus 24%, p=0.045). However, there were no differences in death and myocardial infarction in the 2 groups. On Cox proportional hazard analysis, distal lesion was the independent predictor of MACE (hazard ratio [HR]: 1.99, confidence interval [CI]: 1.129-2.367; p=0.043); IVUS guidance was independent factor of survival free of MACE (HR: 0.414, CI: 0.129-0.867; p=0.033).Conclusion: The use of IVUS could reduce MACE in elderly patients undergoing ULMCA intervention.